Evidence map›Paper›PMID 40528072›Full record

ArticleCEN case reports2025

Renal and gastrointestinal complications following tosufloxacin therapy for suspected mycoplasma infection in a 10-year-old child.

Shigehiro Sainokami, Hirofumi Watanabe, Shoichiro Kanda, Natsuho Adachi, Hiroyuki Tanaka, Keiichi Takizawa, Naoko Sone, Yuko Kajiho, Akiko Kinumaki, Yoshifumi Morita and 3 more

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in CEN case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Shigehiro SainokamiThe Department of Pediatrics, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Hirofumi WatanabeThe Department of Pediatrics, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Shoichiro KandaThe Department of Pediatrics, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan. skanda-tky@umin.ac.jp.ORCID 0000-0001-6674-1221
Natsuho AdachiThe Department of Pediatrics, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Hiroyuki TanakaThe Department of Pediatrics, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Keiichi TakizawaThe Department of Pediatrics, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Naoko SoneThe Department of Pediatrics, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Yuko KajihoThe Department of Pediatrics, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Akiko KinumakiThe Department of Pediatrics, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Yoshifumi MoritaDepartment of Clinical Laboratory, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Teruhiko YoshidaDepartment of Clinical Laboratory, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Makoto KuranoDepartment of Clinical Laboratory, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Yutaka HaritaThe Department of Pediatrics, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Tosufloxacin, a fluoroquinolone antibiotic, is increasingly prescribed for pediatric patients, particularly for macrolide-resistant Mycoplasma pneumoniae infections in Japan. While its efficacy is well-documented, adverse effects such as renal impairment and gastrointestinal symptoms have raised growing concerns. We report a case of a 10-year-old girl who developed sequential symptoms following tosufloxacin administration. On the day after starting tosufloxacin, she experienced right-sided flank pain, followed by the onset of gastrointestinal symptoms, including abdominal pain, diarrhea, and vomiting, on the subsequent day. Contrast-enhanced computed tomography revealed increased fatty tissue opacity surrounding the kidney and duodenal wall thickening, suggestive of localized inflammation extending from the kidney to adjacent structures. Urine microscopy demonstrated needle- and sea urchin-shaped drug crystals, strongly implicating tosufloxacin in the development of renal and gastrointestinal symptoms. This case provides the first evidence suggesting that kidney inflammation may contribute to gastrointestinal symptom onset via localized inflammatory extension. The patient's symptoms resolved promptly with the discontinuation of tosufloxacin and supportive care. This report underscores the importance of monitoring pediatric patients for renal and gastrointestinal adverse effects following tosufloxacin administration.

Indexed as

Anti-Bacterial AgentsFluoroquinolonesGastrointestinal DiseasesKidney DiseasesMycoplasma InfectionsNitro CompoundsOxazinesAbdominal PainChildDiarrheaFemaleHumansJapanKidneyNaphthyridinesTomography, X-Ray ComputedAnti-Bacterial AgentsFluoroquinolonesNaphthyridinesNitro CompoundsOxazinestosufloxacinCast nephropathyDrug-induced tubulointerstitial nephritisTosufloxacin

Identifiers

PMID40528072
PMCPMC12457236

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.